Can I Get a Tummy Tuck if Prone to Blood Clots?

Question

10 years ago when I was 17 I developed a blood clot in my right lung. The doctors devolved it with the use of blood thinners. I have not had any issues since. I have a family history of clots as well. I wanted to get a breast lift and a tummy tuck after having a baby. But worried that I would be high risk and will not be able to do it. Will I be eligible for these surgeries with my history of clotting.

Ronald J. Edelson, MD · Answer

If you have previously had a pulmonary embolism, you are at greater risk of having one with any surgical procedure. There are ways, however, to reduce your risk. Most surgeons will use sequential compression stockings during the surgery as well,as early ambulatory. the tummy tuck procedure is the one that places you at greater risk. Also ,blood clots are directly related to the length of time of your procedure. It is worth considering not combining the procedures to reduce the risk. I agree with the other surgeons on the hematology consult prior to your surgery.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question. Yes, you can still get a tummy tuck but you will likely be higher risk than the average person and special precautions will need to be taken. A referral to a specialist (hematologist) can be done by your regular doctor to make sure that you don't have an underlying medical condition the causes you to clot. Discuss this with your plastic surgeon and follow all recommendations. I hope this helps.

Martin Jugenburg, MD · Answer

A consultation with a haematologist should be obtained.  You will most likely be put on a blood thinner prior to your surgery.  Risks to consider are: there is still a risk of a blood clot even if precautions are taken, and you may have an increased risk of bleeding during and after surgery.  If after your discussion with your hematologist and your plastic surgeons you feel that these risks are acceptable than you can make the decision to proceed.

	(remember there is always a risk of a clot or bleeding and the question is what is your particular risk if all precautions are taken)

	 

	Sincerely,

	Martin Jugenburg, MD, FRCSC

James E. Chappell, MD · Answer

Tummy tuck patients are having a significant surgery. If they have a history of blood clot/clots (pulmonary embolism is what you had, it sounds like) AND a family history of blood clots they should DEFINITELY sit down with their hematologist to discuss risks and perioperative management. The plastic surgeon needs to be in the middle of the whole discussion. Best of luck to you.

Ronald Schuster, MD · Answer

It is most important to find out why you had the blood clots. You should see a hematologist for a complete work up. They will take a good history and get some blood work to investigate. Some patients have some genetic abnormalities that might put you at much higher risk. Other conditions may exist that just make you a little more at risk and surgery could be done provided certain measures are taken to reduce the risk (sometimes this means taking certain medicines). It might turn out that it was just circumstances like taking oral birth control pills, being dehydrated and stuck riding in a car or airplane for several hours.

Kris M. Reddy, MD, FACS · Answer

While you will be higher risk than other patients, you may still be eligible to have surgery. You will need to discuss your history with your surgeon and follow his/her instructions on what will be necessary precautions prior to surgery including the probable need for a surgical clearance from a hematologist. You may also want to to do a tummy tuck and breast lift in stages in order to not further increase your risks. Consult with 3 - 4 experienced and expert board certified plastic surgeons to explore your options.

Milind K. Ambe, MD · Answer

I would definitely have you seen by a hematologist, given your history and your family history of blood clots. Specifically, they should be looking for a Liden Factor V deficiency. Addition, you should make sure that you are not smoking or on oral contraceptives , as those will increase your chance of developing blood clots. Bottom line.. Get a hematology consult and clearance and even consider splitting up thesurgery into two segments. Thanks for your question

Robin T.W. Yuan, MD · Answer

Certainly there is an increase in risk for blood clots in general when performing tummy tucks and with prolonged procedures under general anesthesia. Your history would make surgeons more cautious but not necessarily disqualify you from the surgeries. You will need to coordinate an evaluation and recommendation from your internist and/or hematologist to prepare you for the surgery. On the other hand, anti-coagulation for prevention of blood clots might increase your risk of bleeding in certain surgeries. 

	Careful consultation between specialist is imperative.

	Robin T.W. Yuan, M.D.

Robert L. Kraft, MD, FACS · Answer

The correct physician to whom these inquiries should be directed is a board certified hematologist/oncologist.  I would not operate on a patient without a complete medical history and hematology clearance.  If you are not on blood thinning medication, it would be important to understand the etiology of the clot and your family history in detail far greater than what you have presented in your question  It is impossible to speak specifically  about risks without this information and generaliation is not of value to your individual situation.

Darryl J. Blinski, MD · Answer

Best to be operated upon in an in hospital setting with your hem/onc available if there are any issues.

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